A previously healthy 32-year-old man presented with dyspnea on exertion. Chest radiography showed mediastinal enlargement without pulmonary abnormalities. Magnetic resonance imaging (MRI) showed a mass in the anterior mediastinum with homogeneous gadolinium-diethylenetriamine pentaacetic acid enhancement. An increase in the total serum calcium level (2.98 mmol per liter [normal range, 2.10 to 2.65]) and suppression of thyrotropin (<0.01>
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